Document Detail

Appropriateness of Crohn's disease therapy in gastroenterological rehabilitation.
MedLine Citation:
PMID:  20588039     Owner:  NLM     Status:  MEDLINE    
BACKGROUND/AIMS: The treatment criteria developed by the European Panel on the Appropriateness of Crohn's Disease (CD) Therapy (EPACT) have not been applied to rehabilitation. Thus, we retrospectively evaluated appropriateness of treatments during CD rehabilitation using the EPACT website.
METHODS: We included our 1-year inpatient rehabilitation patients that had been assigned the International Classification of Disease Code for CD. The appropriateness of treatment was assessed in CD categories exhibiting frequent treatment changes. Treatment plans were compared to EPACT recommendations.
RESULTS: Charts of 337 proven CD patients (median age 42 [range 17-65] years, 250 women, median Crohn's Disease Activity Index 140 [range -3 to 427] units) were assigned to EPACT categories. The categories 'steroid-dependent' and 'steroid-refractory' exhibited frequent treatment changes. In these 59 patients, 16 treatments (13 azathioprine, 1 methotrexate, 2 infliximab) were rated as appropriate. One certolizumab treatment was uncertain. 22 treatments with azathioprine were inappropriate (21 due to underdosing), and 93 treatments (30 mesalamine, 59 steroid, 4 budesonide) were not rated. The number of differences between treatment plans and EPACT recommendations decreased from 45 to 25 in both CD categories (p < 0.0001).
CONCLUSIONS: We introduce the EPACT website as a practical advance towards an optimal therapy in rehabilitants with steroid-dependent or -refractory CD.
Christoph Reichel; Jürgen Streit; Karin Ott; Steffen Wunsch
Related Documents :
6342219 - Low-dose maintenance prednisone and antilymphoblast globulin for the treatment of acute...
9001879 - Topical clobetasol propionate compared with placebo in the treatment of unretractable f...
23790469 - Single- and multi-level anterior decompression and fusion for cervical spondylotic myel...
23002259 - Brief report: lateral injection using a whitacre needle with patients in the lateral de...
24073549 - Postoperative sensitivity associated with low shrinkage versus conventional composites.
11875609 - The value of switching from cyclosporine to tacrolimus in the treatment of refractory a...
16336449 - Impact of helicobacter pylori eradication on the anti-secretory efficacy of lansoprazol...
20826719 - Randomized, double-blind trial of fluconazole versus voriconazole for prevention of inv...
12149529 - Effects of fluticasone propionate in copd patients with bronchial hyperresponsiveness.
Publication Detail:
Type:  Journal Article     Date:  2010-06-24
Journal Detail:
Title:  Digestion     Volume:  82     ISSN:  1421-9867     ISO Abbreviation:  Digestion     Publication Date:  2010  
Date Detail:
Created Date:  2010-08-27     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0150472     Medline TA:  Digestion     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  239-45     Citation Subset:  IM    
Rehabilitation Centre Bad Brückenau, Clinic Hartwald, German Pension Insurance, Federal Office, Bad Brückenau, Germany.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Crohn Disease / classification,  rehabilitation*
Logistic Models
Middle Aged
Retrospective Studies
Statistics, Nonparametric
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Acute complications of Crohn's disease: comparison of multidetector-row computed tomographic enterog...
Next Document:  Expression of a hypoxia-associated protein, carbonic anhydrase-9, correlates with malignant phenotyp...